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In a question of mental capacity a woman known as C has been ruled the right to refuse life saving treatment following a paracetamol overdose.

Judge Justice MacDonald has ruled Kings College Hospital NHS Foundation Trust  (KCH) does not have the right to force treatment on the 50-year-old.

He said: “The right to refuse treatment extends to declining treatment that would, if administered, save the life of the patient”

“Where a patient refuses life-saving medical treatment the court is only entitled to intervene in circumstances where the court is satisfied that the patient does not have the mental capacity to decide whether or not to accept or refuse such treatment.” He added.

C suffered kidney and liver damage which means she is left needing dialysis. The procedure removes toxins and excess water from the blood. The process involves being attached to a machine for 3-5 hours at least three times a week.

C believes this would leave her quality of life without it’s former ‘sparkle’.

However Dr S, consultant nephrologist, states there is an 85 to 95% chance that the need for dialysis will only be temporary calling on experience from similar cases.



The mental capacity act 2005 states someone is unable to make a decision if they cannot:

  • Understand the information relevant to the decision.
  • Retain that information.
  • Use or weigh that information as part of the process of making the decision
  • Communicate their decision (whether by talking, using sign language or any other means).


Doctors from KCH argued that C does not have the capacity to make the decision regarding her treatment because she has failed to use the information given to her in recognizing that she could make a full recovery.

Dr R, Consultant Liaison Psychiatrist at Kings College Hospital, said  “We spoke in detail about being able to envisage a future in which she was back up on her feet again with no line in her neck and no pain. She stated that this was not possible ‘they have told me before that I would do that and I am still here’

Dr R also argued that C has been exposed to’back to back psycho-social stressors’

Professor P, who reviewed C’s case, concluded C has been suffering a histrionic personality disorder . The symptoms of which include making irrational decisions and a need to be centre of attention.

Although he admitted it could also be due to her ‘bloody mindedness’ Professor P favoured the conclusion that C’s alleged inability to use and weigh information, specifically concerning her future prognosis, is a product of a personality disorder.

Difficult Family Life

C’s daughter said:”My mother’s values, and the choices that she made have always been based on looks (hers and other people’s), money, and living (at all costs) what she called her “sparkly” lifestyle…her life was, from her point of view, a life well lived. I have never known her express regret, or really to take responsibility for anything, including the choices she has made”.

C’s preoccupation with not getting old  was so profound that she was extremely angered upon learning that she would be a grandmother. Because it made her feel”past her sell-by date”.

C’s daughter added “We think it is a horrible decision. We don’t like the decision at all. But I cannot get away from the fact that she understands it.”

Featured image accredited to Michael Coghlan